- Meeting abstract
- Open Access
Hypoglycemia and hyperglycemia in extremely low-birth-weight infants
https://doi.org/10.1186/1824-7288-41-S1-A7
© Carolis et al. 2015
- Published: 24 September 2015
Keywords
- Hyperglycemia
- Blood Glucose Level
- Hypoglycemia
- Continuous Glucose Monitoring
- Major Congenital Malformation
Background
Materials and methods
All inborn ELBW neonates admitted to our NICU during a 5-year period were eligible for this retrospective analysis. Exclusion criteria were: birth weight (BW) <400 grams, major congenital malformations, death during the first 24 hours of life. Hypoglycemia was defined as blood glucose level (BGL) ≤45 mg/dL; hyperglycemia as BGL>240 mg/dL in a single determination or >180 mg/dL in two determinations at 2-hour intervals. Continuous intravenous insulin infusion was started after an ineffective glucose restriction.
Results
Demographic data and risk factors in the study groups
N-Group N=79 | Hypo-Group N=21 | Hyper-Group N=53 | Hypo&Hyper-Group N=13 | |
---|---|---|---|---|
GA (wks), mean±SD | 26.8±2.0 | 27.7±2.4 | 26.1±2.1 | 26.8±1.8 |
BW (g), mean±SD | 808±136 | 719±140 | 695±146 | 692±140 |
Male, n (%) | 17 (21.5) | 10 (47.6) | 26 (49.0) | 8 (61.5) |
SGA, n (%) | 22 (27.8) | 11 (52.3) | 16 (30.1) | 4 (30.7) |
Apgar1 <6, n (%) | 39 (49.3) | 9 (42.8) | 34 (64.1) | 8 (61.5) |
Apgar5 <6, n (%) | 8 (10.1) | 0 | 9 (16.9) | 2 (15.3) |
Intubation, n (%) | 47 (59.4) | 11 (52.3) | 37 (69.8) | 10 (76.9) |
Antenatal Steroid, n (%) | 64 (81.0) | 17 (80.9) | 41 (77.3) | 12 (92.3) |
RDS, n (%) | 66 (83.5) | 19 (90.4) | 49 (92.4) | 13 (100) |
Sepsis, n (%) | 16 (20.2) | 4 (19.0) | 32 (60.3) | 7 (53.8) |
Inotropic Agents, n (%) | 26 (32.9) | 6 (28.5) | 28 (52.8) | 8 (61.5) |
Xanthines, n (%) | 70 (88.6) | 20 (95.2) | 50 (94.3) | 13 (100) |
Postnatal Steroid, n (%) | 11 (13.9) | 3 (14.2) | 18 (33.9) | 3 (23.0) |
NEC, n (%) | 6 (7.5) | 2 (9.5) | 5 (9.4) | 4 (30.7) |
Medical treatment for PDA, n (%) | 34 (43.0) | 8 (38.0) | 34 (64.1) | 9 (69.2) |
Surgical Procedures, n (%) | 5 (6.3) | 3 (14.2) | 7 (13.2) | 2 (3.7) |
Complications and outcome in the study groups
N-Group N=79 | Hypo-Group N=21 | Hyper-Group N=53 | Hypo&Hyper-Group N=13 | |
---|---|---|---|---|
IVH, n (%) | 17 (21.5) | 7 (33.3) | 25 (47.1) | 8 (61.5) |
IVH (grade 3, n (%) | 5 (6.3) | 1 (4.7) | 15 (28.3) | 4 (30.7) |
ROP all stages in the survivors, n (%) | 49 of 61 (80.3) | 10 of 16 (62.5) | 35 of 35 (100) | 7 of 8 (87.5) |
ROP > stage 2 in the survivors, n (%) | 35 of 71 (57.3) | 9 of 16 (56.2) | 35 of 35 (100) | 6 of 8 (75) |
Mortality, n (%) | 18 (22.7) | 5 (23.8) | 18 (33.9) | 6 (46.1) |
Conclusions
Among ELBW infants, hypoglycemia occurs more frequently in SGA neonates, while hyperglycemia alone or a marked variability of BGL (hypo and hyperglycaemia) is more common in sick neonates. High rate of glucose homeostasis disorders highlights the importance of carefully monitoring BGL in order to a prompt management. Continuous glucose monitoring recently used in neonates [10] might be a useful tool for monitoring glucose changes also in ELBW neonates.
Authors’ Affiliations
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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.